Blog

The fight to undermine the ACA lives on

The decision on March 24, 2017 to indefinitely postpone a vote on the American Health Care Act (AHCA) was a thrilling, but temporary, victory in the campaign to protect the Affordable Care Act (ACA) and Medicaid. Opponents of the ACA still have many opportunities to undermine the ACA and Medicaid. While news reports of new pushes to pass the an amended AHCA or other ACA repeal legislation are likely to persist, many of the most credible threats to the ACA and Medicaid will come from more indirect sources – decisions made by the Trump administration, decisions made by private insurance companies, from budget cuts, or even from offhand comments or tweets. These subtler dangers to our health care system pose serious threats in their own right, but also represent grave risks in the battle for public opinion. We must be ready to drive the public narrative before any sabotage take place, so that any blame for an underperforming ACA system is placed squarely at the feet of those who have deliberately undermined it.

ACA/Medicaid threats on the horizon

Here are threats to the ACA and Medicaid that remain even if there is not an imminent vote on an ACA repeal bill:

  • Discontinuing Cost-Sharing Reduction payments: The ACA provides subsidies – called Cost-Sharing Reductions (CSRs) — to help people with lower incomes pay for out-of-pocket costs (e.g., deductibles and co-payments). Six million people get CSRs and in 2016, 156,500 Illinois Marketplace enrollees received CSRs. The Trump administration has the power – right now – to end these subsidies thanks to a 2015 lawsuit alleging these payments are illegal. This the most clear and immediate risk to the ACA. Without the CSRs, actual premiums paid by clients could go up by 20% or more, insurers would drop out, and enrollment would decrease. This is already causing uncertainty and real harm to the prospects for the 2018 plan year, but could be easily addressed if the Trump administration publicly stated their intent to continue these payments, or if Congress appropriated the necessary funds.

 

  • Poor private insurer participation in the Marketplace: The ACA Marketplace depends on participation by private health insurers. Exits by large insurers such as United Healthcare and Aetna over the last year or two have damaged the law’s standing in the eyes of many and resulted in reduced competition and choice for enrollees. This is a problem – and it could get much worse. Insurers will be announcing from now until June their plans regarding 2018 participation and what they will charge in premiums. High profile exits or large premiums increases could destabilize the market and breathe new energy into the push to repeal the ACA. The uncertainty surrounding the future of the ACA contributes to the flight risk; conversely, agreements to resist short-term tinkering could stabilize the market.

 

  • Administrative policy changes: Many provisions of the law are determined by the Secretary of Health and Human Services and other members of the administration. A number of changes – that the administration can make more or less unilaterally – could weaken the ACA. Some potential changes have already occurred through the “Market Stabilization Rules” that were just finalized this month and some proposed changes include weakening enforcement of the individual mandate, removing funding from the navigator program, and changing the definitions for Essential Health Benefits. Some of these changes do not even require formal public notice and could fly under the radar while doing real damage. Medicaid is also at risk due to an intention to allow states to impose work requirements, premiums, and other barriers in the name of demonstration projects or waivers. We must continue to monitor these actions and publicize them.

 

  • Policy riders: In Congress, controversial legislative changes are hard to pass on their own. They are instead often added to large pieces of legislation that need to pass, like government funding bills. These amendments to larger pieces of legislation are called ‘riders’ and they can do serious damage. In fact, the premium increases seen in 2016 were due in part to a policy rider that prohibited funds from being used to stabilize premium prices (known as risk corridor payments). This is technical and sneaky; but it can have a real impact. Legislation to fund the federal government before a government shutdown is being debated this week. We must be prepared to advocate against attempts to deconstruct the ACA through this back-door.

 

  • Children’s Health Insurance Program reauthorization: The biggest “must pass” health care legislation on deck in 2017 is the reauthorization of funding for the Children’s Health Insurance Program. Opponents of Medicaid could use this reauthorization as a bargaining chip to undermine the adult Medicaid program or other federal health programs. Legislation is likely to be negotiated over the summer and will need to be passed by Sept. 30. We need to monitor progress of this legislation.  It is not too soon to begin talking to representatives and senators about this important re-authorization.

Stay involved and speak out

This laundry list of horrors does not have to come to pass. Advocates must stay vigilant as we navigate this new, less straightforward phase of the campaign. We can and must speak out about them to make sure policy makers know we’re watching. Sign up for Protect Our Care – Illinois email alerts and follow us on Twitter and Facebook to stay up to date.

The most pressing issue for now is funding for the Cost-Sharing Reductions. Please view our CSR fact sheet for ideas on how to speak out.

The opponents of the ACA are counting on us letting our guard down and being able to slip these changes in unnoticed. But we can make them think twice if we let them know we have our eyes on them. And with commitment and a little luck, we can protect the ACA and Medicaid – now and for future generations.

Protect Our Care coalition reacts to defeat of Obamacare replacement plan

After a much-maligned and, according to opinion polls, widely unpopular proposal to replace the Affordable Care Act (Obamacare) was pulled from consideration in the U.S. House of Representatives Friday, the Protect Our Care Illinois Coalition issued the following statement:

CHICAGO – Today’s decision by Republican leadership in U.S. House of Representatives to withdraw a plan to replace the Affordable Care Act (ObamaCare) can be attributed in large part to the valiant opposition that health care consumers, workers, and advocates have mounted against a bill that would have stripped an estimated 24 million Americans of their health insurance, while inflating costs for millions more who remained covered.

It is clear that the campaign to preserve affordable health care for all Americans is strong and impactful. Protect Our Care Illinois thanks every Member of Congress who was prepared to vote this horrendous bill down. As heartened as we are by today’s results, we remain deeply dismayed that so many House members still were prepared to vote for the American Health Care Act, despite the havoc it would have unleashed – and in defiance of public opinion polls that showed sweeping majorities of voters staunchly opposed to the measure.

Indeed, a Quinnipiac poll released yesterday – before the latest revision of the bill had gutted the popular Essential Health Benefits protections included in Obamacare – showed that the ACHA failed to capture support from even a majority of Republican voters.

Here is in Illinois, we urge our Republican lawmakers to consult with their party leaders in Washington to urge them to focus on strengthening the protections in Obamacare that allowed tens of millions of Americans to obtain health insurance and guaranteed coverage for preexisting conditions and essential needs, such a doctor’s visits, lab tests, and maternity care.  These are all legacies of Obamacare that Americans support and the Republican replacement plan would have unraveled.

“Providers, patients, and concerned citizens across the country can breathe a sigh of relief as this ill-conceived bill to repeal the Affordable Care Act (ACA) has been defeated,” said John Bouman, President of the Sargent Shriver National Center on Poverty Law and Protect Our Care Illinois leader. “We hope that leaders in Congress will now abandon their crusade to undermine the ACA and turn their attention to building upon its progress towards a just and humane health care system that cares for all.”

The next moves to expect from opponents of the ACA are unclear at this moment, but regardless, the Protect Our Care Illinois coalition will be ready to defend the six million Illinoisans with pre-existing conditions and the three million Illinoisans with Medicaid coverage who are currently benefiting from the ACA. Health coverage is a matter of life and death in many cases, and efforts to strip coverage from our neighbors must be called out for what they are and defeated.

Protect Our Care Illinois is a statewide coalition of health care advocates, providers, consumers, and workers, working to prevent the repeal of the Affordable Care Act (ACA), prevent disastrous changes to Medicaid, and protect and expand access to quality affordable health care.

Attend an ACA rally today, March 23

Today, the day we should be celebrating the 7th anniversary of the ACA, Speaker Ryan will call the American Health Care Act for a vote in the US House of Representatives. If passed, this bill will:

  • Strip health insurance away from 24 million people, including at least 1 million Illinoisans;
  • Reduce the quality of health insurance for everyone; and
  • Enact permanent and devastating cuts to the Medicaid program.

The bill does this all while giving a massive tax break to the wealthiest Americans and huge corporations.

This week we’ve asked you to do a lot–make phone calls, tweet at your legislator, and go live on Facebook—now we need you to show up. 

We have partnered with groups across the state to host anniversary celebrations, which can now double as protests of the disastrous GOP health bill. Concerned citizens will deliver birthday cake, balloons and pennies (copper is the traditional 7th anniversary gift!) to offices and talk about the danger to their community if the ACA is repealed.

Be heard! Attend one of the events below or grab some neighbors and go the Congressional office nearest you. Either way, be sure to post pictures and videos with #ILsaveACA!

Downtown Chicago Rally

4 p.m. – Kluczynski Federal Building
230 S Dearborn St, Chicago

12th District—Mike Bost

1 p.m. – O’Fallon Office
301, W State Street, O’Fallon

13th District—Rodney Davis

12 p.m. – Champaign Office
2004 Fox Dr., Champaign

3 p.m. – Decatur Office
243 S Water Street, Suite 100, Decatur

3 p.m. –  Maryville Office
15 Professional Park Dr, Maryville

5 p.m. – Taylorville Office
108 E Market, Taylorville

14th District—Randy Hultgren

3 p.m. – Campton Hills Office
40W310 Lafox Rd, #F2, Campton Hills

15th District—John Shimkus

3 p.m. – Maryville Office
15 Profesional Park Dr., Maryville

16th District—Adam Kinzinger

3 p.m. – Ottawa Office
628 Columbus ST, Suite 507, Ottawa

6 p.m. – Rockford
Kate’s Pie Shop Café & Records
6685 E State St, Rockford

18th District—Darin LaHood

12 p.m. – Springfield Office
235 S Sixth St, Springfield

3 p.m. – Peoria Office
100 NE Monroe St #100, Peoria

Watch the webinar: Defending the Affordable Care Act and Medicaid

Dowload the Slides!

This webinar is geared towards newer advocates working to defend access to quality, affordable health care. Watch the webinar to learn about  the latest threats to ACA and Medicaid; advocacy strategies, engagement opportunities, and community mobilization tips; how to connect with current advocacy efforts throughout Illinois; examples of actions you can take TODAY to protect our care; and available advocacy resources and support.

Speakers include:

– Stephani Becker, Senior Policy Specialist, Sargent Shriver National Center on Poverty Law
– Maxx Boykin, Community Advocacy and Social Justice Manager, AIDS Foundation of Chicago
– Scott Cross, Volunteer Lead, Organizing for America-Springfield
– Daniel Rabbit, Project Manager of Health Policy, Heartland Alliance
– Kathleen Winters, Volunteer, The People’s Agenda-Champaign

Click here to download the slides!

Watch the webinar!


Webinar resources

Statement on CBO analysis that reveals 24 million Americans could lose health insurance

Today it was announced that the Republican plans to repeal and replace the Affordable Care Act could cause 24 million Americans to lose health insurance, the independent Congressional Budget Office estimated. The House GOP promised repeal and replace but the latest bill is just repeal and destroy. This proposal takes comprehensive, high quality, affordable health insurance away from millions of Americans, increases out-of-pocket health care costs (particularly for older adults) and destroys Medicaid. It breaks the promises Republicans have made that no one will lose their coverage or see health care cost increase. The Protect Our Care Illinois coalition calls on all members of Illinois congressional delegation to oppose this current proposal. To learn more about the CBO analysis, click here.”

Obamacare replacement bill threatens higher health care costs, less insurance coverage for Illinois consumers, advocates warn

SPRINGFIELD, IL — Nearly one million Illinois working families would either lose their health insurance or face onerous increases in medical costs under the plan to replace the Affordable Care Act (ACA) that Congressional Republicans introduced this week, according to the Protect Our Care Illinois Coalition.

Coalition members urged Illinois’ Congressional delegation, especially the members of the GOP majority in the U.S. House of Representatives, to oppose the legislation, which they described as a prescription for spiraling costs and shrinking coverage in health care available to state residents.   The coalition also cautioned that a bill with such jarring impacts deserves a full public debate, not the indiscriminate headlong rush to passage that has been on exhibition in the nation’s capital this week.

For the 350,000 Illinois residents who purchased private medical coverage on the Marketplace in 2017, higher costs loom as the GOP plan threatens to curb existing tax credits that have trimmed insurance premiums while eliminating financial (“cost-sharing reductions”) assistance that has lowered out-of-pocket expenses that include often-bruising deductibles.

Meanwhile, the plan would reverse the expansion of the Medicaid program, decimating an ACA reform that provided health insurance to 650,000 Illinois residents who had been previously floundering in a coverage void.   Medicaid expansion would devolve back to the states by 2020 under the Republican proposal, leaving beneficiaries at the mercy of an Illinois budget already incapacitated by staggering deficits and with no foreseeable resources to continue to support the program.

Jessica’s ACA Story

Chicago-area resident Jessica Gimeno would be one of those 650,000 Illinois residents caught in the resulting coverage breach.  In 2008 she was afflicted with a rare autoimmune disease that left her hospitalized and bedridden for a year.  Her medical expenses averaged $900 monthly, leaving her financially distressed and physically compromised.  Gimeno subsequently qualified for coverage under the ACA’s Medicaid expansion.

“Medicaid expansion changed my life,” Gimeno said.  “I have not had to worry about the costs of surgery, among many other expenses.  But under this new ACA replacement plan, it appears that I’m doomed to lose my coverage.  If that happens, it’s no exaggeration to say I fear for my life.  I was in this plight before Medicaid expansion, so I know just how precarious conditions are without it.”

With ramifications this dire, members of the Protect Our Care Illinois Coalition condemned the cloak of secrecy that surrounded deliberations on the bill and ensuing haste to pass it with minimal public input – even before the Congressional Budget Office, a non-partisan agency that reviews the financial implications of legislation has had an opportunity to appraise its impacts.

“It is disastrous and reckless to jam a law through the House in one week that will literally impact millions of people in Illinois and tens of millions across the country, Claudia Lennhoff, Executive Director of Champaign County Champaign County Health Care Consumers (CCHCC), a Protect Our Care Illinois member said. “The people of Illinois want and deserve an open and transparent process, with actual coverage and budget implications from the CBO.”

The coalition urged all Illinois residents to contact their Congressional representatives at http://protectourcareil.org/index.php/take-action-page/, and ask them to oppose the legislation.

The American Health Care Act: fewer people covered, weaker protections, higher costs and deep cuts to Medicaid

Last night, House Republicans released their so-called replacement bill, the American Health Care Act, which would repeal broad parts of the Affordable Care Act (ACA) and make radical and harmful changes to Medicaid that would result in millions of people losing their health care. It’s no wonder the bill’s drafters kept the content a secret as long as possible.

There is more information below on what the Republican bill does, but we need you to act now.

Call your Representative NOW, 202-224-3121 and demand that they stand strong in support of the ACA and do not vote to strip health care from millions.  Call the Capitol switchboard, 202-224-3121, and enter your ZIP code to find out who your Representative is. Click here to find out who your Representative is ahead of time.

Here is what you can say:

Hello, my name is _____ and I am a resident of Illinois. I am calling to demand that Representative ____ vote against repealing the ACA and cutting Medicaid funding. The American Health Care Act is not an adequate replacement that protects my care!

TAKE ACTION to #ProtectOurCare, Call your Representative at 202-224-3121

There are three Illinois Republican House Members on the two committees debating the bill this week. They need to hear from you, too!

House Ways and Means
Peter Roskam – CD 6 @PeterRoskam  (202) 225-4561

House Energy and Commerce  

John Shimkus – CD 15 @RepShimkus (202) 225-5271
Adam Kinzinger – CD 16 @RepKinzinger (202) 225-3635

Background
New polling shows that more than two thirds of voters want to keep what works in the Affordable Care Act and fix what doesn’t, rather than repeal and replace the current law. Despite this, Republicans in Congress are rushing to vote on a bill that will:

  • Benefit the wealthy and healthy at the expense of those who are low-income and sick.
  • Make coverage less accessible and less affordable – including a 30% “sick tax” on people who have a break in coverage.
  • Increase out-of-pocket costs while eliminating many of the ACA’s benefits and consumer protections.
  • Make deep cuts to Medicaid and cap federal funding for the program – which will result in reduced access to coverage and benefits for seniors, people with disabilities and children and shift costs to states.

Since there is no scoring from the Congressional Budget Office, we don’t know how much this plan will cost or how many people will lose coverage because of it. Yet, tomorrow at 10 am EST, two key House Committees, Ways and Means and Energy and Commerce, will begin the “mark-up” of the bill, just 1 day after sharing their plan with the American people. (For reference: when the Affordable Care Act was passed in the 111th Congress, the bill was posted online for public review for 30 days before the first committee markup. In addition, the House of Representatives conducted 79 committee hearings and debates over a two year period.)

We deserve careful consideration of any changes to health insurance that will impact family’s lives, financial security, and access to health care. More importantly, we deserve the right to understand the proposed changes so that we can ask questions and share our concerns with those elected to represent us.

Illinois Groups Call on Elected Officials to “Protect Our Care,” Announce State-Based Coalition to Fight Health Care Repeal and Medicaid Caps

Contact: Dave Lowitzki
Campaign Manager
(c) 312-296-5802
info@protectourcareil.org

[February 23, 2017] – Today, as Illinois Members of Congress are back in their districts, Protect Our Care Illinois, a statewide coalition of consumer health advocates and providers, call on elected officials to stop the dangerous path towards repealing the Affordable Care Act (ACA) and dismantling Medicaid with no viable replacement.  The Protect Our Care Illinois Coalition, which launched its official online presence today, currently has over 50 members including lead agencies Access Living, ACLU of Illinois, AIDS Foundation of Chicago, Chicago Coalition for the Homeless, EverThrive Illinois, Health & Medicine Policy Research Group, Heartland Alliance, Illinois Coalition of Immigrant and Refugee Rights, Legal Council for Health Justice, SEIU Healthcare Illinois Indiana, the Sargent Shriver National Center on Poverty Law and Thresholds.

Despite public disapproval, congressional Republicans are rushing down a chaotic path that could take health coverage away from 30 million people – including 1.2 million Illinoisans — and raise premiums for millions more. “Repealing the ACA will not protect our care,” said John Peller, Protect Our Care Illinois Coalition member and President/CEO of the AIDS Foundation of Chicago. “Instead it will diminish coverage for millions of people in Illinois and threaten the local economy.”  As Illinois grapples with an unprecedented budget crisis, repealing the ACA will result in a loss of 114,000 jobs in our state, a loss of $113.8 billion in business output between 2019 and 2023, and a loss of $2.0 billion in state and local taxes. Jobs loss would be felt across the economy and especially in rural areas, with 39,000 lost jobs in health care and 75,000 in other sectors during the first year of repeal.

The Congressional Republican plans for replacements and “repairs” don’t add up.

Every ACA “replacement” or “repair” proposal covers fewer services, for fewer people, at higher costs to the consumer. For example, the recent proposal from Congressional Republicans offers tax credits based on age and not income.  As a result, a 50-yr. old millionaire would receive the same tax credit as a 50-year-old low-wage worker. Health Savings Accounts (HSAs) are another common element of Republican proposals. HSAs impose higher out-of-pocket costs and little help for moderate to low income families; instead HSAs merely allow wealthier people to shelter more of their income from taxation. High risk pools won’t help either:  prior to the ACA, high risk pools cost Ilinoisans with pre-existing conditions 150% more in premiums for plans with inadequate coverage and dangerous lifetime limits. These have all been tried before – they don’t work.

Protect Our Care Illinois coalition members demand that Illinois’ Congressional Delegation publicly oppose a repeal of the ACA and any Medicaid block grant or Per Capita Cap proposal. Both would rip care from millions and cause chaos through the whole health care system. Here’s what at stake for Illinois families if Congressional Republicans continue the path towards repeal:

  • Kids will lose free preventive services, like vaccinations and vision screenings
  • Seniors will pay more for prescription drugs due to the reopening of the donut hole
  • People with disabilities and chronic illnesses will lose protections against discrimination
  • Adults and children will lose protections against annual and lifetime limits.

Here are some of the stories of Illinois residents as told to the Protect Our Care Illinois coalition:

Jeannie from Chicago, IL:
I am a self-employed 63-year-old woman. I have “pre-existing conditions” and a chronic illness. Before the ACA, the only insurance available to me was very expensive catastrophic-type health insurance with extremely poor coverage and a sky-high deductible. Thanks to the ACA, not only can I get decent health insurance, but the ACA guarantees that basic health encounters such as wellness visits, mammograms, etc. are available to me at no cost. Thanks to the ACA, I was finally able to see a specialist and receive proper diagnosis and treatment for the conditions that are causing my chronic pain. I have no idea what I will do without the ACA.

Heather from Wood River, IL:
While I was in college, I was able to remain on my parent’s health insurance so that I could focus on school rather than a career path and college at the same time. I have a congenital birth defect as well, which without coverage, I would be hundreds of thousands of dollars in debt. Repealing the ACA without anything to help people with disabilities means that those of us suffering with preexisting conditions could die, or be forced into major debt.

Andrea from Anna, IL:
I was blessed to not have a lapse in coverage because my COBRA ran out in December 2013. I have a pre-existing condition and would be unable to work without medication and regular doctor visits. I have also had several hospital stays and emergency room visits since January 2014, which my insurance paid most of. The ACA is the reason I can work without trying to find a full time job with benefits. Without the tax credits to help pay premiums and coverage for my pre-existing condition I would once again be unable to get health insurance.

Individuals and organizations are encouraged to join the Protect Our Care Illinois coalition here: http://protectourcareil.org/  And be part of the conversation on Twitter: @ProtectILCare and Facebook: https://www.facebook.com/ProtectOurCareIL

ACA/Medicaid Expansion Talking Points for Meetings with Conservative Legislators in Illinois

In-district meetings with elected officials will be critical in defending the Affordable Care Act (ACA), especially with Republicans who have voiced support for the ACA repeal. They need to know how the ACA repeal will impact their constituents. Below are some talking points to help you organize what to share. You certainly don’t need to touch on all of these points, but think of this as a menu for what could be helpful in speaking to a conservative lawmaker about the ACA.

Don’t vote to repeal the ACA without a replacement plan that provides comprehensive coverage for at least as many people as the ACA does

  • This is the most important message – make sure they know that is what you expect as a constituent
  • If on a relevant committee (Rep Roskam (IL-6), Rep Shimkus (IL-15), Rep Kinzinger (IL-16)), press them to oppose irresponsible ACA repeal plans in committee
  • Try to get a commitment on these points

The ACA is working for my program and those we serve

  • Mention any new staff you have been able to hire
  • Any new sites or programs you have been able to start
  • Any services your program participants can now access that they couldn’t before
  • Share how the new staff, sites, and services are lowering costs and aiding the economy
  • Share what the landscape was like for your program before the ACA and how it has improved post-ACA – emphasize that you don’t want to go back to the pre-ACA days

The ACA has helped real people in our communities

  • A program participant who has turned their life around thanks to the ACA
  • Someone who has had their life saved or avoided financial ruin thanks to the ACA
  • A friend or family member who benefited thanks to the ACA
  • Stories related to how the ACA is helping to combat the opioid epidemic

Repealing the ACA would harm my program and those we serve

  • Share any numbers or analysis you might have done on how losing ACA-related revenue would impact your program’s budget
  • Any expected layoffs or closures in the event of an ACA repeal
  • Impact on specific populations like seniors, people with disabilities, kids, women, or those struggling with mental illness or substance use disorders

It is irresponsible to repeal the ACA without a replacement plan available to the public

  • We are very concerned about what might replace the ACA, and so far, we haven’t seen a replacement plan
  • Governor Rauner and many other conservative Governors and Senators have expressed concern over repealing the ACA without a full replacement. Where do you stand?
  • We hear from participants and community members all the time about how they’re worried about what is going to happen
  • Why is the replacement plan not public? The public has a right to know what you’re proposing before you repeal what is currently working
  • Congress needs to be careful and thoughtful – you should not rush. The ACA only passed after hundreds bipartisan of hearings and almost a year of debate. It should not be undone in a matter of weeks.
  • The Marketplace will collapse without a viable replacement – even if repeal is delayed

Our sector can’t handle any further disruption after the Illinois budget crisis

  • Share how stretched thin you already are due to delayed payments, having taken out lines of credit, and other consequences of the two year state budget impasse

Helpful Rebuttals to Arguments for ACA Repeal or Medicaid Block Grants/Per Capita Caps

Advocates should be prepared to push back against likely criticisms of the ACA and certain conservative proposals. This is critical so that lawmakers who state such talking points feel the pressure and discomfort with their current proposals from their constituents. We want them to think twice about towing the party line and want to hold them accountable when they state misleading points.

Don’t worry – we will replace the ACA with something terrific

  • Press them on the specifics of the plan – will it cover the same number of people? Will people get the same or more financial support? Will current enrollees keep their coverage? Will it cover the same services?
  • There is much talk about reducing costs, but reducing costs for whom? Will costs for low and moderate income beneficiaries go down? How will that be achieved?
  • Get them to explain how the replacement plan would impact your programs

We will retain the popular parts of the law, like prohibiting pre-existing condition discrimination, prohibition on annual and lifetime caps, and other insurance regulations

  • Press them for how they propose to keep the popular parts without the individual mandate. Other states have tried that and it has not worked. How do they plan to keep these requirements and still keep costs down?
  • They may mention requiring people to have ‘continuous coverage’ in order to qualify for insurance with a pre-existing condition. Continuous coverage means you cannot go without insurance, which is very difficult for low income families or people who experience a crisis like job loss or sudden health needs.

The ACA is collapsing on its own

  • Medicaid expansion is working great for our program and those we serve
  • Over one million people have gotten insurance through the ACA – about 650,000 in Medicaid and 350,000 on the Marketplace
  • More people have signed up on the Marketplace this open enrollment than ever before
  • The ACA needs improvement, but don’t throw the baby out with the bathwater. Why not just improve it? Repair the ACA rather than causing all this chaos.

Costs are spiraling out of control

  • Repealing the ACA will not help rising health care costs, which have been increasing for years – long before the ACA
  • The ACA has actually helped slow the growth of health care costs
  • Most of our program participants and neighbors with ACA coverage are on Medicaid or receive a subsidy, making coverage affordable

Don’t worry – the repeal is delayed

  • A delayed repeal will cause chaos – how can we plan for the future? How will the uncertainty affect the economic growth?
  • The Congressional Budget Office estimates that the non-group insurance market will likely collapse without a replacement, even if the repeal is delayed, leading to 18 million people losing coverage nationwide the very next year and premiums spiking after that

Medicaid expansion is crowding out the ‘truly needy’

  • Access to care for Medicaid enrollees has not diminished since Medicaid expansion – in fact, it has improved as providers have been able to invest in new staff and facilities thanks to Medicaid expansion dollars
  • Many who qualify under Medicaid expansion are truly needy. Most individuals experiencing homelessness and many of those struggling with severe mental illness or addiction qualify under Medicaid expansion.

Medicaid expansion has caused waitlists for seniors and people with disabilities

  • Waitlists have existed for many years and are actually increasing at a slower rate since the ACA was passed than they had the previous decade
  • Waitlists in Illinois are caused by insufficient funding of our home and community based services programs. Without Medicaid, this funding deficit would be much worse.
  • Access to nursing homes and home and community based services for seniors and people with disabilities is not limited by the Medicaid expansion population – it is limited by state funding and eligibility requirements. The infusion of federal dollars from Medicaid expansion has helped the state avoid further waitlists and restrictions.

Block grants will give the state needed flexibility in its Medicaid program and control costs

  • Governor Rauner has so far expressed concern about Medicaid block grants. Aren’t you concerned about how this could impact our state and our precarious budget situation?
  • All Medicaid block grant proposals and similar reforms would dramatically cut federal funding and shift costs to the states. This will harm my program and the state.
  • States need resources in order to be innovative and take advantage of any flexibility –how can we be innovative with significantly less money?
  • There is nowhere to reduce Medicaid spending further in Illinois. Medicaid spending has grown much more slowly that private insurance and Illinois has very low rates.
  • The Illinois behavioral health 1115 Medicaid waiver is very innovative and crafted under the current Medicaid structure. But it needs resources and Medicaid expansion to work!
  • Most of the flexibilities we’ve heard about are work requirements, waiting lists, and higher costs for Medicaid beneficiaries. The people we serve who depend on Medicaid will have a hard time meeting those requirements because of their circumstances. What happens to them? They will likely end up in the ED, a hospital or institution, or jail if they go without care.